Audit on the Laboratory Diagnosis of Malaria Parasites at the University of Gondar Hospital Laboratory, Northwest Ethiopia

Abstract

Background: Malaria remains a heavy burden on tropical communities. In Ethiopia 65% of the population is living in 75% of the country at risk of malaria. Following correct laboratory procedures and identifying malaria parasites are of paramount importance in the laboratory diagnosis of malaria parasites. The aim of this audit was to assess the quality assurance system of malaria diagnosis in the University of Gondar (UOG) hospital against the established standards for the audit.
Methods: The clinical audit was conducted using a structured questionnaire, direct observation on laboratory activities, and re-examining the diagnosed slides confidentially. Standards were set for blood collection, the staining of blood films, the quality of the blood films, and reporting systems.
Results: Of the 214 blood samples examined for malaria parasites, 66 were true positives, 0 false positive, 7 false negatives and 141 true negative. Moreover, the wiping of the first drop of blood during capillary puncture, failure to filter Wright's staining solution on daily bases, and failure in the use of high- power objective during microscopy were among the highly violated standards with few areas of good practices.
Conclusion: In this audit, the false negative rate of malaria parasite microscopic examination in the UOG Hospital Laboratory which was 5% was significant. Replacing Wright's staining solution by Giemsa’s stain, preparing SOPs, and establishing internal quality control programs are recommended.